News Roundup: Will GLP-1 Drugs Revolutionize Addiction Treatment?

New research on GLP-1 drugs like Liraglutide and Ozempic shows the potential for incredible impact on addiction.

There are some remarkable research studies trickling out that look at the impact of GLP-1 drugs like liraglutide and semaglutide (Ozempic) on addiction. We may be on the brink of a new treatment paradigm. We will be publishing some longer pieces soon on this topic, but for now, here’s the most exciting recent research.

📉 GLP-1 Inhibitor reduces opioid cravings by 40% in small study (STAT)

Liraglutide, one of the new wave of GLP-1 agonists for diabetes and weight loss drugs, dramatically reduced opioid cravings compared to placebo in small a 20-person randomized trial. Since there are several GLP-1 drugs already FDA approved for diabetes and obesity, the path to approval for addiction may be much shorter than novel therapies. And if results like these keep coming, there will likely be physicians prescribing off-label before long.

🌲 Patients Who Take Ozempic for Diabetes or Obesity Have Less Cannabis Addiction Disorders (Molecular Psychology)

Researchers looking at patient health records found that patients treated with semaglutide (Ozempic / Wegovy) showed a large reduction in the likelihood of both new and recurrent cannabis use disorder (CUD) compared to patients treated with non GLP-1 anti-obesity or anti-diabetes medications.

Patients treated for Type 2 diabetes showed a 60% reduction in likelihood of CUD and patients treated for obesity showed a 44% reduction. These are huge drops.

What’s really incredible here, of course, is that this is a side effect! Preventing cannabis addiction was not a goal of these semaglutide prescriptions. While this is a correlation study, the approach is closer to what might be called a natural experiment, making this data extremely compelling.

Particularly exciting is that the same research team will soon be publishing similar papers looking at the impact of Ozempic on treatment for opioid use disorders, alcohol use disorders, and smoking.  If these papers show similar effects, there could be a cascade of activity that soon follows in labs and clinics. I’m optimistic.

In a hint of the significance of this work, this paper was co-authored by Nora Volkow, the Director of NIDA, which brings us to our next article.

🎤 Nora Volkow, Director of the National Institute on Drug Abuse says GLP-1 Drugs are ‘Very, very exciting’ (STAT)

Please, please read this article by Lev Facher at STAT. There’s so much here that captures the promise and potential in front of us and also the needless obstacles that are in the way:

“The pharmaceutical industry has never spontaneously embraced us and said, ‘We want to help develop treatments.’ No, no, no,” Volkow said. “We go to them …. and say, please, please, we have an obligation.”

…

“This is a structural problem that we have: That we’ve never considered addiction as a disease that is worthwhile to invest in, despite the very high rate of mortality,” she said. “We need to change those priorities. We need to see that if we don’t tackle the problem of addiction — that if we don’t treat [it] like other diseases, we are going to continue to face this horrific epidemic of deaths.”

…

In a statement, Eli Lilly said it doesn’t have any studies planned to investigate tirzepatide, the ingredient in Mounjaro and Zepbound, as a treatment for addiction. It “collects and evaluates data about its medicines to see where they may provide benefit beyond their current indications,” Lilly said.

Fortunately, there are some GLP-1 drugs that are towards the end of their patent life which may make research easier going forward. We’ll be writing a detailed exploration soon of GLP-1 evidence, reasons why big pharma actively avoids research in this area, and some strategies to potentially move things along more quickly.

🍷 Significant Decrease in Alcohol Use Disorder Symptoms Secondary to Semaglutide Therapy for Weight Loss: A Case Series (Journal of Clinical Psychiatry)

Researchers identified patients who had alcohol use disorders (AUD) before starting semaglutide.  They compared their AUD scores before and after starting semaglutide and saw a large decrease in alcohol use. This is similar methadology to the CUD paper above but with a much, much smaller sample size.

“Retrospective chart review was utilized to identify patients treated with semaglutide for weight loss who also had positive screenings for AUD on the Alcohol Use Disorder Identification Test (AUDIT; score > 8 considered positive) prior to initiation of semaglutide therapy. Six patients were identified who met these criteria. A paired t test was utilized to compare initial AUDIT scores with AUDIT scores after initiation of semaglutide therapy… All 6 identified patients (100%) had significant reduction in AUD symptomatology based on AUDIT score improvement following treatment with semaglutide (mean decrease of 9.5 points, P < .001).”

For context, a decrease of 9.5 on the AUDIT test is huge. A drop that big can take someone from the ‘high risk’ category all the way down to ‘low risk’. But again, this is a tiny study of just 6 people.

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We’re a new non-profit, mostly volunteer, research and policy team focused on the incredible opportunity that emerging addiction treatments are creating to finally provide lasting long-term solutions for the addiction crisis. We are looking for more volunteers to join our effort, particularly MDs, PhDs, and other experts in the field of addiction, pain, and health policy. Please be in touch!